Estimating ADHD Prevalence and ADHD-Associated Health Care Costs Based on Claims Data

Speaker(s)

Seck K1, Witte J1, Beyer AK2, Schlack R2, Neuperdt L2, Hölling H2, Kuhnert R2, Romanos M3, Jans T3, Berner A3, Hetzke L3, Weyrich S3, Hauer D3, Scholz V3, Ulsamer S3, Wallau C3, Ravens-Sieberer U4, Kaman A4, Gilbert M4, Heuschmann P5, Fiessler C5, Horn A5, Widmann J5, Riederer C6
1Vandage GmbH, Bielefeld, Germany, 2Robert Koch Institute, Berlin, Germany, 3University Hospital Würzburg, Würzburg, Germany, 4University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 5University of Würzburg, Würzburg, Germany, 6DAK-Gesundheit, Hamburg, Germany

OBJECTIVES: Attention deficit/ hyperactivity disorder (ADHD) is one of the most frequently diagnosed mental disorders among children and adolescents. To assess ADHD prevalence and health care costs associated with ADHD diagnosis we used claims data of individuals aged 0-17 years and insured with one of the largest German statutory health funds (DAK-Gesundheit).

METHODS: Our data set encompasses 717,065 observations in 2018, 736,675 observations in 2019 and 760,023 observations in 2020. We used various strategies to estimate ADHD prevalence using documented diagnoses and prescriptions for approved ADHD drugs. Additionally, we compared average per capita costs for health care services between individuals with and without documented ADHD diagnosis.

RESULTS: Considering individuals having a documented diagnosis in at least one quarter of the year, we estimate a prevalence of 4.02% (95%-CI:3.97%;4.06%) in 2018, 4.07% (95%-CI:4.03%;4.12%) in 2019 and 3,96% (95%-CI:3.92%;4.00%) in 2020. Using the criterion of at least two quarters with a documented diagnoses, estimated prevalence is slightly lower with 2.93% (95%-CI:2.89%;2.97%) in 2018, 3.01% (95%-CI:2.97%;3.04%) in 2019 and 2.88% (95%-CI:2.84%;2.91%) in 2020. Using the combination of at least one ADHD diagnosis and at least one prescription for an ADHD drug, estimated prevalence becomes 1.65% (95%-CI:1.62%;1.68%) in 2018, 1.69% (95%-CI:1.66%;1.72%) in 2019 and 1.65% (95%-CI:1.62%;1.68%) in 2020. For the age group 7-17 years, per-capita health care costs are around three times higher for individuals with documented ADHD diagnosis than for their peers without documented ADHD diagnosis. No difference in costs was detectable for children between 0-6 years.

CONCLUSIONS: Our results show that different strategies to identify ADHD prevalence yield differing prevalence estimates stressing the importance of carefully considering identification criteria to ensure that estimates based on administrative data are informative. Furthermore, our results show that adolescents with an ADHD diagnosis exhibit higher average per-capita health care costs compared to their peers without diagnosis.

Code

EPH123

Topic

Epidemiology & Public Health, Health Policy & Regulatory

Topic Subcategory

Public Spending & National Health Expenditures

Disease

No Additional Disease & Conditions/Specialized Treatment Areas